The frequency, treatment and clinical outcomes of stent thrombosis after use of TAXUS™ stent

Background and Objectives: Findings from randomized controlled trials have showed that there is no difference in the development of stent thrombosis (ST) in patients implanted with drug-eluting stents (DES) as compared to the use of bare metal stents. The aim of this study was to evaluate the incidence, clinical characteristics, and clinical outcome of ST after implantation of TAXUS™ stents in routine clinical practice. Subjects and Methods: This was a retrospective, single center cohort study. The study included 1,584 patients that underwent successful TAXUS™ stent implantation (2,513 lesions treated) between May 2004 and Dec 2006. Results: ST developed in 18 patients (1.14%) of the 1,584 patients. Acute ST occurred in one patient (0.06%), subacute ST occurred in nine patients (0.57%), and late ST developed in eight patients (0.51%). Sixteen patients that developed ST received medication with dual antiplatelet agents. The incidence of ST in patients with acute coronary syndrome (ACS) showed was higher than in patients with stable coronary disease. The mean follow-up duration for patients was 13.3 months. There were 13 myocardial infarctions and 3 deaths attributable to ST. Conclusion: The cumulative incidence of ST that was confirmed by angiography after successful TAXUS™ stent implantation in consecutive "real-world" patients was substantially higher than the rate reported in clinical trials. Patients with ACS should be treated more aggressively as the risk of stent thrombosis is higher than for patients with stable angina. A large prospective study for the identification of predictors of DES thrombosis should be conducted.